Tracheal intubation is a procedure involving the placement of a tube through the oral cavity, larynx, vocal cords and into the trachea. A laryngoscope is commonly used to view the glottis during placement of the endotracheal tube. The endotracheal tube often has a cuff that is inflated to form a seal with the interior walls of the trachea to prevent aspiration into the lungs.
Endotracheal intubation in patients with a difficult airway is commonly performed using a fiberoptic or video bronchoscope or endoscope. The endoscope is passed through the vocal cords, and once the tracheal rings are identified, endotracheal position of the endoscope is presumed, and the endotracheal tube (ET) is passed blindly through the vocal cords into the trachea until the ET becomes visualized by the lens at the tip of the endoscope. The blind delivery of the tube into the trachea cn result in injury to the vocal cords, particularly in the case of a partially obstructed airway.
Current endoscopes used for endotracheal intubation have a small diameter of 4-5 mm so that an ET tube can be fed onto the endoscope, and then guided by the endoscope into the trachea. These fiberoptic scopes have only one (vertical) angulation direction. To change the direction of the endoscope in the horizontal direction, body movement is used. This limited steerability and the small diameter makes the handling of the endoscope in patients with a difficult airway frequently difficult as the maneuverability of the tip is limited and the tip of the scope is frequently deflected by the tissue.
Thus, there is a continuing need for improvement in devices for endotracheal intubation, particularly for difficult airway intubation.